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Allergic rhinitis and asthma are highly related to indoor and outdoor allergens. A common weed, Chenopodium album is one of these outdoor aero-allergens. In the literature, data about specific characteristics of children with C. Album sensitization is limited. In this study, we aimed to evaluate demographic and clinical characteristics of patients with Chenopodium album sensitization in a cross-sectional study. The patients and two control groups included in the study were found to be sensitized to Chenopodium album following skin prick tests in an allergy clinic over a period of one year. The patients and control groups completed a questionnaire consisting of items regarding demographics and clinical characteristics. The frequency of Chenopodium album sensitizationwas 9.4% (47/502). The distribution of these patients diagnoses was: 48.9% allergic rhinoconjunctivitis (ARC), 19.1% allergic rhinitis (AR), 12.8% ARC + asthma, 8.5% asthma, 4.3% asthma + AR. Allergic rhinoconjunctivitis was statistically higher than in the control groups (P: 0.008, P: 0.001). Allergic rhinitis symptoms and ocular symptoms occurred together in 51% during the pollination period of Chenopodium album, whereas 17% of the patients were asymptomatic between August-September. Forty percent of the patients had accompanying sensitization to animal dander (cat and/or dog dander), which was statistically high compared to control group 1 (P: 0.001). In conclusion, Chenopodium album sensitization is highly related to rhinoconjunctivitis. Children with ocular symptoms must be evaluated for Chenopodium album sensitization. These children can also be expected to have a high animal dander sensitization rate.

Identifying allergen distribution is meaningful and significant for effective diagnosis and treatment of allergic diseases. This study compared the allergen sensitivity in four southern China cities. We enrolled 55,432 participants (27,408 male, 28,024 female) between 2007 and 2019. The allergen-specific IgE levels were compared by the χ2 test. The five prevalent sensitivities were for mite mix (10,985, 19.82%), cockroach (4,860, 8.77%), crab (4,450, 8.03%), fish mix (3,874, 6.99%), and house dust (3,486, 6.29%). Almost all allergen sensitivities decreased with age, particularly from infant to middle aged participants (p < 0.05). An exception was Shenzhen, where food allergen positive rates remained constant in all age groups studied. The proportion of male sensitive to at least one food allergen (OR 1.130; 95% CI 1.088-1.174, p < 0.0025) or aeroallergen (OR, 1.117; 95% CI, 1.078-1.158, p < 0.0025) was higher than female in all four cities. Except for dog dander and tree mix, all aeroallergens differed significantly between seasons (p < 0.05). Liuzhou had the highest rates of food allergen- and aeroallergen-positive participants. The allergen-specific IgE distribution differed among the studied cities, with significant seasonal differences. Young age, male sex, and aeroallergens were risk factors for allergic disease.

Background Chemical communication is an important aspect of the behavioural ecology of a wide range of mammals. In dogs and other carnivores, anal sac glands are thought to convey information to conspecifics by secreting a pallet of small volatile molecules produced by symbiotic bacteria. Because these glands are unique to carnivores, it is unclear how their secretions relate to those of other placental mammals that make use of different tissues and secretions for chemical communication. Here we analyse the anal sac glands of domestic dogs to verify the secretion of proteins and infer their evolutionary relationship to those involved in the chemical communication of non-carnivoran mammals. Results Proteomic analysis of anal sac gland secretions of 17 dogs revealed the consistently abundant presence of three related proteins. Homology searches against online databases indicate that these proteins are evolutionary related to ‘odorant binding proteins’ (OBPs) found in a wide range of mammalian secretions and known to contribute to chemical communication. Screening of the dog’s genome sequence show that the newly discovered OBPs are encoded by a single cluster of three genes in the pseudoautosomal region of the X-chromosome. Comparative genomic screening indicates that the same locus is shared by a wide range of placental mammals and that it originated at least before the radiation of extant placental orders. Phylogenetic analyses suggest a dynamic evolution of gene duplication and loss, resulting in large gene clusters in some placental taxa and recurrent loss of this locus in others. The homology of OBPs in canid anal sac glands and those found in other mammalian secretions implies that these proteins maintained a function in chemical communication throughout mammalian evolutionary history by multiple shifts in expression between secretory tissues involved in signal release and nasal mucosa involved in signal reception. Conclusions Our study elucidates a poorly understood part of the biology of a species that lives in close association with humans. In addition, it shows that the protein repertoire underlying chemical communication in mammals is more evolutionarily stable than the variation of involved glands and tissues would suggest.

Allergic diseases, affecting a variety of organs, have continuously increased both in developed and developing countries. Tobacco smoke exposure increases prevalence of allergic rhinitis (AR) and may affect allergic sensitization. This study was designed to compare indoor-aeroallergen sensitization between those not exposed and exposed to tobacco smoke in university students and staff with allergic rhinitis. A cross-sectional descriptive study among university students and staff with allergic rhinitis was performed from February 1, 2018, to March 31, 2019. Questionnaires regarding demography, clinical symptoms, and tobacco smoke exposure were implemented. A current smoker was defined as using, at least, 1 cigarette per day for, at least, 1 month. A secondhand smoker was defined as the one who never smoked, but lived with a current smoker, at least, for 1 month. A skin prick test for eight common indoor aeroallergens, Dermatophagoides pteronyssinus, Dermatophagoides farinae, Periplaneta americana, cat dander, dog dander, para grass, careless weed, and Cladosporium spp., was performed. Sensitization was defined as positivity to, at least, 1 aeroallergen. One hundred and twenty-eight adult patients were eligible participants for the study, and 68 cases (53.10%) were classified as having tobacco smoke exposure. Among these, most of them were secondhand smokers (50 cases, 73.50%). There was no statistically significant difference between exposure and nonexposure to tobacco smoke and indoor aeroallergen sensitization, except for the Periplaneta americana antigen (p=0.013). Most of those in the nonexposure group (34 cases, 56.70%) were classified as having intermittent allergic rhinitis, whereas the tobacco exposure group had significantly more prevalence of severe clinical symptoms. In conclusion, tobacco smoke exposure did not appear to have much influence on aeroallergen sensitization for 7 of the 8 antigens examined. However, for the Periplaneta americana antigen, there was a highly significant correlation with patients experiencing worsened allergic rhinitis symptoms. Overall, it was observed that allergic rhinitis patients exposed to tobacco smoke had more severe clinical symptoms. Future studies should look for other potential antigens of interest, such as mould. Implementation of public health practices reducing exposure to tobacco smoke could have benefits in allergic rhinitis patients.

Pet allergens follow aeroallergens as a common cause of asthma and rhinitis in children (1,2). Specifically, cat and dog dander are typical triggers of these symptoms(1). However, high percent of patients with severe asthma can be sensitized to other mammals, such as horses and mice(3). This is not limited to occupational or rural areas where exposure to this animal is more prevalent. A high rate of sensitization to horses in people with no known direct exposure who live in urban areas is well documented(4). This article is protected by copyright. All rights reserved.

Objective To determine the optimum storage temperature for serum allergen specific IgE antibodies (sIgE) to common food and inhalant allergens. Methods Patient sera with sIgE concentrations ≥ 0.7 kIU A /l were pooled accordingly: pool 1—peanut and hazelnut, pool 2—egg white, cow's milk and cod fish, pool 3—soy, wheat and shrimp and pool 4—dust mite Dermatophagoides farinae , dog dander, cat dander, Timothy grass pollen, and silver birch pollen. Aliquots stored frozen, refrigerated and at room temperature were tested in duplicate (Phadia ImmunoCAP® 250) over two weeks. The relative difference was calculated for each sIgE as a percentage of the initial value and compared to the analytical reference change value. Results Minimal effects on specimen stability were noted for all sIgE analyzed under the three storage conditions tested in this study. All changes observed in sIgE concentrations were related to the assay variability and not to sample deterioration. Conclusion Serum allergen specific IgE concentrations are stable at all temperatures studied for up to 17 days.

Few studies shed light on trans-regional differences in allergen sensitization between vast regions within a similar latitudinal range but with distinct geomorphological features. We aimed to detect specific IgE (sIgE) positivity to common allergens in populations from two southern China provinces. Using a uniformed protocol, serum was collected from 2778 allergic patients in coastal Guangdong and inland Yunnan, and examined for sIgE to local allergens including house dust mite, cockroach, tree pollen mix, mold mix, dog dander, crab, shrimp, egg white and milk. The overall sIgE positive rates were 58.4% in patients from Guangdong vs 61.0% from Yunnan. House dust mite (d1) was the most common allergen in both regions, figure 1. Among d1-sensitized patients, only 35.7% (208/583) in Guangdong and 22.9% (147/642) in Yunnan tested positive for house dust mite alone. Among those poly-sensitized d1-positive subjects, cockroach was the most common co-sensitizing aeroallergen in either province. 41.9% of the d1-sensitized Guangdong subjects had class 4 or higher response, in drastic contrast to a very low percentage of such reactivity in Yunnan subjects. However, a high proportion of d1-sensitized patients in Yunnan (36.3%) were concomitantly positive for tree pollen mix, figure 2. Surprisingly, Yunnan patients showed high sIgE-positive rates for crabs and shrimps, either by an overall or by age-group analysis, compared with their Guangdong counterparts (both P

U Kack, A Asarnoj, H Gronlund. J Allergy Clin Immunol. 2018;142(4):1113–1120.e9 To analyze patterns of immunoglobulin E (IgE) reactivity to dog allergen components in sensitized children and investigate the association between those patterns and clinical symptoms by nasal provocation tests (NPT). Children 10 to 18 years ( n = 60) with known sensitization to dog identified by a skin prick test wheal >3 mm or serum-specific IgE >10 kU/L were included. NPTs were performed with a commercial dog extract by using a standardized protocol. The extract was analyzed by radioallergosorbent test inhibition and contained all 6 dog allergens (Can f 1, 2, 3, 4, 5, and 6) used in subsequent analyses. The allergens were present in a wide range of concentrations. Serum-specific IgE levels to dog extract and each of the allergenic components were measured. All but 2 children had allergic rhinitis or conjunctivitis, and 41 out of 60 …

Background/PurposeEnvironmental factors, different ages, and detection methods might affect the profiles of allergy sensitization and confound the diagnosis of allergic diseases. The purpose of this study was to investigate the different profiles of allergen sensitization in different ages, geographic areas, and detection methods.MethodsWe analyzed the patients who received allergen sensitization tests by the automated microfluidic-based immunoassay system (BioIC) method at Show Chwan Memorial Hospital in Changhua City and at Chang Bing Show Chwan Hospital in Lu-gang from January 2011 to December 2011. Results were compared in different ages (3–6, 7–18, and ≥19), different geographic areas, and different detection methods and analyzed by Chi-square or Fisher exact test depending on sample size.ResultsA total of 1145 patients were analyzed. The younger the age, the higher the food allergy sensitization rate is found (26.6% vs. 14.7% vs.11.1% p

Aim of our study was to evaluate the importance of atopy patch testing with aeroallergens as a diagnostic method in patients suffering from atopic dermatitis. Method: The complet dermatological and allergological examinations were performed in 29 patients; 10 men, 19 women with the average age of 27.8 years, min. 17, max. 57 years; with the median SCORAD 24.2 points, s.d. 13.3 points. Wormwood, grass, dog dander, cat dander, dermatophagoides pharinae, dermatophagoides pteronyssinus and birch pollen were examined in diagnostic procedures. Skin prick tests, specific IgE were examined; the atopy patch tests were performed with aeroallergens for skin prick tests in concentration 1× skin prick tests. Results: Specific IgE and skin prick tests to one or more tested aeroallergens were positive altogether in 27 patients; atopy patch tests were positive only in one of these patients. Conclusion: For atopy patch testing with aeroallergens the concentration of 1× skin prick tests is low to confirme the eczematic reaction in patients suffering from allergy to inhallant allergens.

Mechanical laundry is an effective tool for the environmental control of allergens, but the optimal conditions for removing allergens are not yet clear.To evaluate the optimal conditions of mechanical laundry for the removal of house dust mite (HDM), dog dander, and pollen allergens.The 4 washing modes of 30 degrees C (86 degrees F), 40 degrees C (104 degrees F), 60 degrees C (140 degrees F), and steam water (SW) with detergent were evaluated. Allergen removal performance was assayed using a 2-site enzyme-linked immunosorbent assay (ELISA) or an ELISA inhibition test.Using the 30 degrees C and 40 degrees C washing modes, only 6.5% and 9.6% of Dermatophagoides farinae, respectively, were killed. However, using the 60 degrees C and SW washing modes, all HDMs were killed. The amounts of Der f 1 remaining after the 30 degrees C, 40 degrees C, 60 degrees C, and SW washing modes were 26.8%, 2.4%, 1.3%, and 0.6%, respectively, with unmanipulated contaminated sheets. The effects of rinse on Der f 1 levels after the 30 degrees C washing were greater compared with those after the 40 degrees C, 60 degrees C, and SW modes. The amounts of Can f 1 in the extractions after washing were 0.3% to 1.3% for all modes, and all extracts, even without a rinse, did not inhibit specific IgE binding to dog allergens according to ELISA. The remaining pollen allergen levels after washing were lower in the 60 degrees C and SW modes than in the lower temperature modes. However, the levels did not differ among the various washing modes after rinsing once.Water temperature and number of rinses are critical factors for the removal of HDM, dog dander, and pollen allergens.

There is a well-documented relationship between allergic disease and allergen exposure. It is important to institute measures that reduce allergen exposure in the treatment of all types of allergic disease, including asthma and allergic rhinitis. These measures include reducing exposure to both indoor environmental allergens, such as dust mite and cat/dog dander, as well as outdoor pollens, like tree, grass, and weed pollen.

Allergens extracts from cats and dogs dander were prepared by extraction, followed by purification and fractionation by gel filtration. One major peak was obtained from cat dander with a molecular weight 35KDa, where as two major peaks were obtained from dog dander with a molecular weight 21 and 18 KDa. Total and specific IgE ELISA test was performed on 137 patient’s sera samples. The rate of the total IgE positive ELISA results was (72.99%). From the total IgE positive, it was found that the rate of the specific IgE positive ELISA results was 49% in case of patients examined with cat dander and 29% in patients examined with dog dander. There was significant difference (P

To survey airborne and food allergen patterns in southern Taiwan and to analyze the effect of age on response to different allergens, we tested samples from 4,411 allergic patients at Kaohsiung Medical University Hospital using the MAST-CLA test (new Taiwan panel). A total of 2,212 (50.1%) samples showed a positive response. We grouped allergic patients into five age groups. Milk and egg white were the main food allergens in the younger groups (< 3 years old and 3-6 years old). Shrimp, crab, and shellfish were the main allergens in the groups aged 7-12, 13-18, and more than 18 years. Among airborne allergens, house dust and mites Dermatophagoides farinae and D. pteronyssinus were the main allergens in all age groups, whereas the frequency of response to cockroach allergen was low in the group aged less than 3 years, but increased in the other age groups. There was a sharp increase in the frequency of response to airborne allergens after 3 years old and a sharp decrease in response to food allergens. Among subjects allergic to both airborne and food allergens, there was a positive MAST-CLA rate of 19.9% to 26% (all five age groups, no significant difference). When we compared our results with those from Taipei Veterans General Hospital in northern Taiwan, there were significant differences for yeast, peanut, feather mix, dog dander, cockroach, D. farinae and D. pteronyssinus allergens (p < 0.01). These differences were probably caused by differences in patient location, patient age, disease patterns and allergen panels.

Two in vitro assays for the detection of allergen-specific IgE (sIgE) were compared reestimating sera with sIgE to common inhalants (birch t3, timothy g6, mugwort w6, cat dander el, dog dander e5, housdust mite D. pter. dl) and food allergens (FA) (hen's egg fl, cow's milk f2, wheat flour f4, soy bean f14, hazelnut f17, apple f49). Quantitative values (kU/l) of both systems were associated to different degrees depending on the allergen: allergen/n t3/48, g6/47, w6/39, e1/40, e5/42, d1/39. Spearman's rho 0.95***, 0.9***, 0.82***, 0.9***, 0.82***, 0.85***, allergen/n f1/37 f2/38 f4/68 f14/52f17/40 f49/40. Spearman's rho 0.84***, 0.6***, 0.6***, 0.31*, 0.68***, 0.82***, *** p < 0.001; * p < 0.05. Values to inhalants (t3, g6, el, e5) were scattered moderately around an ideal regression line (diagonal between x-and y-axis). In contrast, sIgE-levels to FA (f2, f4, f14, fl7) showed stronger discrepancies between both systems. Similarly, different degrees of association and spreading, depending on the individual allergen, were found comparing semiquantitative classes (0 - 6) of both systems. Taken together, values of sIgE to inhalants detected by different in vitro methods are stronger associated than sIgE to FA; IgE-values to allergens with one dominant major allergen (i.e. t3, el) seem to be more concordant than complex allergen mixtures (i.e. dl); identical units (kU/l) can not garantee equivalent IgE results. The data presented do not allow estimates of the real IgE concentrations or judgement on superiority of one of the tests over the other. The study is restricted to compare both methods analytically, since the diagnostic concordance could not be calculated due to a lack of corresponding clinical data. Despite these limitations, comparative sIgE studies are necessary and helpful to define the concordance of IgE values detected by different immunoassays. They also set the basis for subsequent improvement of allergens used in test systems detecting specific IgE.

Background and methods: Dog dander is one of the most important indoor allergens in Nordic countries. Due to the population flow into cities, the number of dogs in urban areas has increased. Dog allergens can be found practically everywhere indoors. We measured allergen content in indoor air and dust during dog shows. Results: In facilities used for dog shows, the dog allergen content was exceptionally high, up to 2 100 000 ng Can f 1/g dust, but it can be reduced by proper cleaning. The efficiency of cleaning will remain poor if furniture and textiles are not cleaned or the distribution of airborne allergen cannot be prevented. Conclusions: Dog shows should not be held in public facilities, such as schools, where a significant proportion of occupants are hypersensitive to dog allergens and may therefore suffer symptoms due to the exposure to dog dander.

Sensitization to dust mite allergens can be determined by means of a skin-prick test (SPT) or by measurement of specific IgE antibodies in serum (sIgE). In our study, concordance of the results of both methods was analyzed on the basis of reproducible SPT results. Three consecutive SPTs were performed on 138 school children (age 6-8 years) at one-year intervals. SIgE was determined at the end of a two-year observation period. Seven common inhalant allergens (Dpt, Df, birch pollens, hazel pollens, grass pollens and cat and dog dander) were analyzed. The majority of subjects with positive SPT reactions to the respective allergen also showed sIgE (Dpt: 82/86; Df: 53/53; cat dander: 31/32; dog dander: 6/9; birch pollens: 29/31; hazel pollens: 22/22; grass pollens: 37/37). A significant correlation between the SPT [weal diameter (P1) or allergen/ histamine ratio (P2)] and sIgE was found for Dpt (P1 = 0.004/ P2 = 0.016), birch pollens (P1 = 0.002/P2 = 0.0001) and grass pollens (P1 = 0.0005/P2 = 0.0001). There was also a significant correlation between sIgE to Dpt and to either Der p 1 (p = 0.0001) or Der p 2 (p = 0.0001), as well as between sIgE of both major allergens (p = 0.0001). In the analysis of co-sensitization of Dpt and Df, most subjects sensitized to Dpt were also sensitized to Df (57/91). Children with sIgE to Dpt (n = 87) usually showed sIgE to Df(n = 83). In this study, SPT and sIgE results are concordant and appear equivalent when using reproducible SPTs. Therefore, in the case of a positive Dpt result, additional testing for sensitization to Df can be regarded as redundant when Dpt and Df are the major contributors to the allergen content of house dust.

Background Asthma is the most common chronic disease affecting children and adolescents (AD). We evaluated the prevalence of asthma and associated factors in adolescents living in a developing region in northeast Brazil using the ISAAC ( International Study of Asthma and Allergies in Childhood ) methodology. Methods According to the ISAAC protocol, AD (13–14 year olds, n = 3,043 in 2003 and 3,009 in 2011–12) answered the standardised written questionnaire by themselves. In addition, in 2011–12 a random sample of these AD ( n = 430) also answered a complementary questionnaire (associated factors) and underwent a skin prick test with aeroallergens ( Dermatophagoides pteronyssinus, Blomia tropicalis, Blatella germanica, Periplaneta americana , dog dander, cat dander, mixed grass pollen and mixed moulds, including 10 mg/mL histamine and negative controls). Data were analysed by univariate and multivariate analysis using Poisson regression. Results The prevalence of asthma in 2011–12 in Aracaju was 12.8%, which is lower than that recorded in 2003 (18.7%). Individuals with a dog outside the home (PR = 0.93; 95%CI = 0.88–0.98; p = 0.018) and those with an older sibling (PR = 0.94; 95%CI = 0.91–0.98; p = 0.005) were identified as protective. The presence of smokers in the residence (PR = 1.04; 95%CI = 1.00–1.09; p = 0.039) was associated with an increased risk of developing asthma. Conclusions The prevalence of asthma was significantly lower than the last ISAAC figures reported for Aracaju. Tobacco smoking, a preventable factor, continues to be associated with an increase in the occurrence of asthma and other associations may concur with the hygiene hypothesis.

Purpose A retrospective study on the prevalence of sensitization to cat and dog dander in patients with allergic conjunctivitis. Methods 284 patients with allergic conjunctivitis (124 males-160 females), with age from 18 to 70 years old (mean age: 42.30 for males, 41.35 for females), underwent skin prick tests (SPTs) to cat and dog dander according to current guidelines. Results The results showed that more frequent allergens (positive SPTs) were cat dander 67/284 (23.59%), while dog dander showed lower positivity rates 44/284 (15.49%). As regards gender, 33 from 67 patients with positivity to cat dander were males and 34 were females. The numbers for sensitivity to dog dander were 20 males and the rest 24 females, indicating no sex predilection. Conclusion Symptoms and signs of ocular allergy are very common and may be related to sensitization to cat and dog dander among other factors. The patients with allergic conjunctivitis included in our study tended to have positivity to cat rather to dog dander. No sex predilection was observed.

BACKGROUND This study evaluated the diagnostic performance of naturally purified allergen-molecules compared to that of allergen-extracts for house dust mite, cat dander epithelium and dog dander. METHODS In vitro tests for allergen-specific IgE were performed on the IMMULITE(®) 2000 in serum samples from 66 allergic patients. RESULTS House dust mite: specificity for the allergen-extract (D1) and the allergen-molecules (nDer p 1, nDer f 1, nDer p 2 and nDer f 2) is comparable. The allergen-extract has a significantly higher sensitivity (100%) and total agreement (TA) (93%) relative to sensitivity (57%-70%) and TA (76%-81%) of the individual allergen-molecules. Cat dander epithelium: sensitivity (90%), specificity (96%) and TA (94%) of the allergen-molecule (nFel d 1) are comparable to those of the allergen-extract (E1). Dog dander: The allergen-molecule (nCan d 1) and allergen-extract (E5) have comparable specificity and TA. The allergen-extract has a lower sensitivity (52%) than the allergen-molecule (71%), although not significant (p=0.125). CONCLUSIONS There is no diagnostic benefit of using allergen-molecules instead of allergen-extracts for initial allergy screening on cat dander epithelium and dog dander. However, use of these allergen-molecules might contribute to better standardization of the specific IgE tests. The studied allergen-molecules for house dust mite are of minor diagnostic value, because of loss of sensitivity.

Hongmei Zhang1,*, Wilfried Karmaus1,*, Jianjun Gan2, Weichao Bao1,*, Yan D Zhao3, Dewi Rahardja3, John W Holloway5, Martha Scott4,5, Syed Hasan Arshad4,51Department of Epidemiology and Biostatistics, The University of South Carolina, Columbia, SC, USA; 2GlaxoSmithKline, Research Triangle Park, NC, USA; 3Department of Clinical Science and Simmons Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA; 4The David Hide Asthma and Allergy Research Center, St Mary’s Hospital, Newport, Isle of Wight, UK; 5School of Medicine, University of Southampton, Southampton, UK *These authors contributed equally to this articlePurpose: Skin prick testing (SPT) is fundamental to the practice of clinical allergy identifying relevant allergens and predicting the clinical expression of disease. Wheal sizes on SPT are used to identify atopic cases, and the cut-off value for a positive test is commonly set at 3 mm. However, the measured wheal sizes do not solely reflect the magnitude of skin reaction to allergens, but also skin reactivity (reflected in the size of histamine reaction) and other random or non-random factors. We sought to estimate wheal sizes exclusively due to skin response to allergens and propose gender-specific cutoff points of atopy.Methods: We developed a Bayesian method to adjust observed wheal sizes by excluding histamine and other factor effects, based on which revised cutoff points are proposed for males and females, respectively. The method is then applied to and intensively evaluated using a study population aged 18, at a location on the Isle of Wight in the United Kingdom. To evaluate the proposed approach, two sample t-tests for population means and proportion tests are applied.Results: Four common aeroallergens, house dust mite (HDM), grass pollen, dog dander, and alternaria are considered in the study. Based on 3 mm cutoff, males tend to be more atopic than females (P-values are between 0.00087 and 0.062). After applying the proposed methods to adjust wheal sizes, our findings suggest that misclassifications of atopy occur more often in males. Revised allergen-specific cutoff values are proposed for each gender.Conclusion: To reduce the gender discrepancy, we may have two potentially convenient solutions. One way is to apply allergen-specific and gender-specific cutoff values following the proposed method. Alternatively, we can revise the concentration of allergens in the SPT solutions but keep the cutoff values unchanged, which may be more convenient to clinicians.Keywords: SPT, atopy, Bayesian method, joint modeling, misclassification

In clinical work I formed the impression that the potency of Phazet lancets, for cat and dog allergens, was lower than earlier and too low to diagnose all clinically sensitive children with cat and dog allergy. Therefore, I decided to investigate the potency of newly produced and several years old Phazet lancets coated with dog and cat allergens. Twenty-six adults with case histories of cat and/or dog allergy and skin reactive to extracts of either dog dander or cat epithelium were skin prick tested in duplicate with one old batch and one newly produced batch of Phazet dog and/or cat lancets as well as the in-house reference of cat and/or dog allergen, 100,000 BU/ml. The potency of Phazet lancets in relation to the standard was evaluated by the median slope of the allergen dose-response relationship. The potency of the old dog lancets (mean 48,900 BU/ml) was higher (NS) than that of the newly produced lancets (mean 28,000 BU/ml), and the potency of both types of lancets was significantly less (P < 0.001) than that of the dog allergen in-house standard. On the other hand, the potency of newly produced (123,000 BU/ml), but not old (108,000), cat-allergen-coated Phazet lancets was higher than that of the cat allergen in-house reference extract (P = 0.048). There was a marked variation in potency between patients. Most of this variation was due to factors varying between patients, not between lancets, indicating that the composition of the allergen on the lancets was partly different from that of the standard.(ABSTRACT TRUNCATED AT 250 WORDS)

We investigated the positivity rates to various allergens in asthmatic children who visited our hospital, using a skin test and a radioallergosorbent test (BAST). The positivity rates determined by a skin test were as follows: house dust (HD) 64%, Alternaria 17%, Candida 5%, Cladosporium 2%, Cocksfoot 36%, Japanese hop 22%, cat epitherium 32%, dog dander 17%, buckwheat 13% and egg white 8%. When compared to the reported results in the other areas, the positivity rates to pollens and cat epitherium were higher and those to HD and fungi except for Alternaria were lower. Similar results were obtained by the determination of allergen-specific IgE antibody using RAST. We further studied whether the positivity rates in ashmatic children with other allergic diseases were different from those in children with bronchial asthma alone; although the rate to Cocksfoot (54%) was higher in the presence of allergic rhinitis, it is interesting that children with bronchial asthma alone showed a positivity rate of 32%. These findings indicate that the sensitization to allergens varies in different geographical areas and may be influenced by climatic and personal environments.

Twenty-four asthmatics allergic to cat and/or dog dander were included in a study to examine the efficacy and safety of immunotherapy (IT) with partially purified, standardized extracts of cat or dog dander. In the first placebo controlled, double-blind part of the study, 10 patients were treated with extracts of both cat and dog, 12 with cat extracts and 2 with dog extracts. Fifteen patients received active IT and 9 placebo injections. Patients treated with both extracts received active extracts only, or placebo only. Bronchial allergen challenge after 5 months demonstrated a significant fall in sensitivity to cat (P = 0.04) in patients treated with cat extracts. No significant changes were found in sensitivity to dog after treatment with dog dander extract or in the placebo groups. During this period, bronchial sensitivity to histamine did not change significantly in any of the groups. To examine the effect of more prolonged IT, 19 patients allergic to cat (17) and/or dog (9) were treated for 12 months. Bronchial sensitivity to cat decreased further (P = 0.003), while no significant change was found in dog extract-treated patients. In cat extract-treated patients a significant decrease in bronchial histamine sensitivity developed (P = 0.02). Systemic side effects were few, but in some cases, local side effects were a dose-limiting factor. This study demonstrated that IT with cat extract may benefit cat-allergic asthmatics, whereas no influence of IT with dog extract was detected in dog-sensitive asthmatics.

Background Little information or data are available concerning the stability and compatibility of dog epithelia and dog dander allergens. Objective To determine the immunochemical reactivities of commercial, nonstandardized dog epithelia and dog dander extracts after exposures to various temperatures or after mixing with high-protease fungal and cockroach extracts at concentrations recommended for maintenance immunotherapy (IT) injections. Methods Quantitative enzyme-linked immunosorbent assay and qualitative (immunoblot) analyses were performed to compare specific compositional changes with total or individual allergen activities. Assays for dog allergens Can f 1 and Can f 3 (albumin) used specific mouse or rabbit antibodies. Multiallergen enzyme-linked immunosorbent assay inhibition and immunoblot methods were conducted using a human serum pool with high levels of IgE to dog allergens. Results Dog allergen recoveries ranged from 22% to 134% after short exposures to moderate or extreme temperatures and from 28% to 118% after mixing with fungal or insect extracts and storage for up to 15 months at 2°C to 8°C. Recoveries in dog dander extracts varied up to 2.5-fold with different test methods. Immunoblots revealed partial degradation of dog albumin molecules to discrete fragments that retained antibody-binding activities. In most cases, recoveries improved at elevated glycerin concentrations. Conclusions Dog allergens in epithelia and dander extracts exhibited favorable temperature stabilities. Compatibilities with fungal or insect extracts may be compromised or at risk in some combinations. These data support current IT practice parameter recommendations of separating high-protease extracts from other products if possible; they also demonstrate that dog extracts possess allergen stabilities suitable for many IT formulations.

Paper disk RAST test is widely used for assay of serum specific IgE antibody. Recently, a new assay technique for it, called CAP system, is available from Pharmacia.We utilized CAP system to titrate serum specific IgE antibodies and compared the results with those of RAST and skin prick test. One hundred twenty-six patients with allergic diseases were studied. Serum specific IgE antibodies to 15 allergens were measured by fluorometric CAP system. Then we performed RAST with same sera and skin prick test to the same patients. Correlations between the results of CAP and those of RAST were good in inhalant allergens except for house dust and also in food allergens. CAP system seemed to have better sensitivities than RAST for inhalant allergens, especially for dog dander and for Japanese ceder. As concerns house dust, CAP had less sensitivity than RAST and the correlation between them was not good. Correlations between CAP and spin prick test were also good, and CAP had better sensitivities than skin prick test for inhalant allergens. As a result, CAP system appeares to be a reliable good in vitro test for measuring serum specific IgE antibodies providing some other advantages.

Aim: To compare the patterns of Type 1 sensitization of common food and aeroallergens among infants and older patients with atopic dermatitis (AD). Methods: All skin prick tests (SPTs) performed over a 6-month period were examined, and patients with urticaria were used for comparison. Results: Dust mite was the most common aeroallergen and dog dander the least common. Egg white was the most common food allergen and beef the least common. Dust mite and peanut sensitization was more prevalent in AD than in urticaria. Dust mite sensitization was more prevalent in older children than infants with AD. Cow's milk sensitization only occurred in one-tenth of these patients. Prevalence of sensitization to common aeroallergens, but not food allergens, was generally higher in children beyond 5 years of age. Conclusion: Milk sensitization is far less prevalent than egg white, and the prevalence does not change beyond infancy. There is no significant change in prevalence in many of the common food allergens beyond infancy. Many infants with AD develop eczema before they show atopy to the common food and aeroallergens. The SPT information is useful in reassuring parents of the unlikelihood of severe Type 1 immediate IgE reaction to some of the common food and aeroallergens, so that empirical and multiple food avoidance/restriction can be avoided.

Methods Cross-sectional study that evaluated 193 elderly patients with asthma followed at an outpatient tertiary service. Patients were considered when asthma met the criteria of GINA 2012 anamnesis and pulmonary function demonstrating reversibility. These patients were evaluated for gender, current age, age at onset of asthma, lung function and asthma classification. The assessment of atopy was performed by searching for total IgE and specific IgE (in vivo or in vitro) for house dust mites, molds, cat and dog dander, cockroach and grass.

The purposes of this study were to examine milk allergic patients to determine concomitant reactivity between milk, beef, pork and cat and dog dander and other common inhalant allergens.19 patients were selected according to their Immuno-CAP results, which had increased Ig-E levels against milk, pork or beef. Patients were also tested against Johnson grass, short ragweed, cat/dog dander and d. farina.Pearson's test revealed strong correlation between beef and pork, beef and milk, pork and milk Ig-E counts (consecutively r2 = 0.89, r2 = 0.81, r2 = 0.60 and p0.01. All cat allergic patients also appeared to be allergic to either beef/pork meat or milk. The correlation between pork and dog dander Ig-E counts was also significant (r2 = 0.38, p0.01). No correlation detected between milk-meat-pet and grass-weed-dust allergies.Patients who are known to have pet allergies may need to be screened for meat and milk allergy. Milk allergic patients may also need to avoid cows and pork meat.

Fruits belonging to the Cucurbitaceae family 1 have been reported to be one of the most important allergycausing fruits in the United States. To the best of our knowledge, although pumpkin is a member of the above family and allergy to roasted pumpkinseed has been described, we have not found any indexed report concerning allergy to this fruit. The aim of our study was to describe the clinical and immunologic findings in this first reported case of allergy to pumpkin. CASE REPORT The patient was a 28-year-old woman with a history of rhinoconjunctivitis and asthma who was allergic to pollens and cat dander. She was referred to our clinic after development of several episodes of itching of the mouth, angioedema of the lips and face, generalized itching, and mild dyspnea within 15 minutes after eating pumpkin soup or thin vermicelli (sweet made from the fibrous part of the pumpkin). The patient required treatment with inhaled bronchodilator, antihistamines, and methylprednisolone in the emergency unit. She had not consumed any other food, beverages, or drugs coinciding with these episodes. In vivo tests Skin prick tests to an aeroallergen commercial battery (pollens, mites, fungi, and cat and dog dander) according to European Academy of Allergology and Clinical Immunology (EAACI) guidelines were positive to cat dander and most of the tested pollens (grasses, trees, and weeds). The skin prick-by-prick test responses with fresh fruits were positive to pumpkin (10 × 9 pseudopoda) and also to other Cucurbitaceae fruits: cucumber (5 × 4 mm), zucchini (4 × 3 mm), muskmelon (7 × 6 mm), and watermelon (7 × 3 mm). The open oral challenge test response to fresh pumpkin, according to the previously described method, 2 was positive, and it was also positive for cucumber, muskmelon, and watermelon. In vitro assays The pulp of several Cucurbitaceae fruits was processed according to the method previously described. 2 The initial protein content of the extracts was enriched by a method based on ion-exchange chromatography.3 The protein concentration of all fruit allergenic extracts was adjusted to 1 mg/mL.

Results: The sensitization rates to Tree pollen mixture I and II were increased as 5.0%, 6.8% in 2000, 8.5%, 9.8% in 2005, and 14.8%, 17.3% in 2010, respectively (trend P < 0.001, P < 0.001, respectively). And the sensitization rates to D. pteronyssinus cat dander and dog dander were changed as 55%, 4.8%, 4.8% in 2000, 62.2%, 11.9%, 28% in 2005, and 63.1%, 12.7%, 16.7% in 2010, respectively. The distribution of sensitized pollens was oak (12.8%), beech (12.4%), pine (10.3%), birch (10%), hazel (9.6%), alder (8%), elder (6.9%), elm (5.4%) in the study of 2010. When allergen/histamine ratio was compared, rates of strong sensitization over 4+ to tree pollen were increased. Conclusion: The sensitization rates to inhalant allergens were increased in children with asthma or allergic rhinitis from a tertiary re- ferral hospital in Seoul over last 10 years. Especially, an increase in the degree of skin reactivity was observed in cat dander, dog dan- der, and tree pollens. The studies to investigate the etiology of this increase and prevention will be needed. (Allergy Asthma Respir Dis 2014;2:97-102)

PURPOSE: The higher prevalence of respiratory allergic disease may be due to increased exposure to inhalation allergens. We conducted a survey of allergic diseases in autumn and winter with detection of major indoor allergens in major cities in Korea. METHODS: We enrolled 110 subjects from the fourth Korea National Health and Nutrition Examination Survey with stratified, cluster, and systematic sampling procedures. All participants answered a health questionnaire as well as underwent a skin prick test (SPT) and ImmunoCAP for 11 indoor major allergens. We also measured the levels of 5 major allergens (Der f 1, Der p 1, Can f 1, Bla g 1, and Asp f 1) in fine indoor dust from the houses of 60 subjects with a 2-site ELISA. RESULTS: The prevalence of allergic rhinitis and asthma were 25.5% and 7.3%, respectively. The most common sensitized allergens identified by SPT and ImmunoCAP were Dermatophagoides farinae (40.9%, 36.8%), followed by cockroach (23.6%, 19.5%), mugwort (13.6%, 22.9%), oak (9.1%, 22.9%), Japanese hop (9.1%, 8.6%), and dog dander (8.2%, 6.9%). There was a modest discrepancy between SPT and ImmunoCAP. Der f 1 and Der p 1 were detected in 91.7% and 45.0% of the enrolled houses, respectively. Der f 1 indicated high concentrations in all specific provinces in Korea; however, Der p 1 measured high only in the south. Dog dander allergens were present in 71.7% of houses; however, Bla g 1 was present in only 11.7% of houses and Asp f 1 was not detected in any houses. CONCLUSIONS: The most important inhalant allergens in Korea are house dust mites followed by cockroach, mugwort, oak, Japanese hop, and dog dander in indoor environment, in which The dominant species of house dust mites were different according to region.

Rationale This transversal study aimed to establish the possible differences of cutaneous sensitization to common aeroallergens in patients under 14 years-old. Methods This study was conducted from 1998 to 2002 on 3047 patients, from the Southwest of Madrid region (Spain). These patients were referred to our allergy unit due to respiratory symptoms (rhinitis and/or asthma). The first skin prick tests (SPT) to the most common aeroallergens in our environment performed to each patient were analyzed. A SPT of 3 mm larger than saline was considered positive. Patients were classified into seven age groups: 0-1 (n=16), 1-2 (n=42), 2-3 (n=124), 3-4 (n=177), 4-5 (n=245), 6-10 (n=1238), 11-14 (n=1205). Results 56.1% of patients were male. The prevalences of sensitization found were as follows: grass pollen: 52.8%, olive pollen: 41.5%, D. Pteronyssinus: 8.6%, dog dander: 19.5%, cat dander: 21.8%, alternaria: 13.5%, cockroach: 2.4%. The prevalence of positive SPT for each allergen was different among the age groups (p Conclusions In our study, cutaneous sensitization begins in the 2nd year of life and the maximum appears in the 10-14 years-old group. No gender differences were noted except in grass pollen, in patients older than 4 years-old.

Rationale Patients with AR and BHR have a higher risk of developing asthma. In this study, we investigated whether reactivity to aeroallergens in skin prick test (SPT) and serum eosinophil cationic protein (sECP) levels could be used to predict BHR in AR. Methods Fifty-nine consecutive patients diagnosed with AR between February 2001 and February 2002 were studied. SPTs were performed using grass, tree, weed, parietaria, Alternaria , Aspergillus , mites and cat and dog dander extracts. Methacholine challenge test was performed using spirometry. Results Methacholine induced BHR was detected in 23 patients (39%). Of the 59 patients, 14 had one positive SPT response, 35 had 2-4 and 10 had >4 positive responses. There was a significant inverse correlation between methacholine PC 20 doses and the number of positive SPTs (p=0.031, r=−0.28). BHR(+) patients had a mean of 4 positive SPTs while BHR(-) patients had a mean of 2.6 (p=0.04). Of the 23 BHR(+) patients, 39% had >4 positive SPTs. In contrast, only 2.7% of the BHR(-) patients had >4 positive SPTs (p=0.0001). The mean methacholine PC 20 dose was 5.05 ± 9.72mg/ml in patients with >4 positive SPTs, 23.4 ± 14mg/ml in patients with 2-4 and 23.6 ± 13.4mg/ml in patients with one positive response (p=0.001 for >4 vs. 2–4, P=0.002 for >4 vs. 1). There was no correlation between sECP levels and methacholine PC 20 doses. Conclusions AR patients with SPT responses to a higher number of allergens are more likely to have BHR. Whether the number of positive SPT responses correlates with the risk of developing asthma in AR remains to be determined.

Summary Simultaneous conjunctival and nasal provocation tests, a total of 174 test pairs, were carried out in fifty patients with allergic rhinitis, using serially diluted antigen solutions of birch, Timothy grass and mugwort pollen, as well as cat and dog dander. The nasal mucosa was found to be more sensitive than the conjunctival mucosa in ninety-six test pairs (55 %). This differs from earlier reports. Nasal reaction only was observed in twenty-nine instances (17%). Posterior rhinomanometry was also used to evaluate test reactions, but was found to yield little additional information. In 43 % of nasal provocation tests, which according to other criteria were positive, the rhinomanometric results were negative. Despite a fairly good correlation between the results obtained by nasal and conjunctival challenge, the results point to organ specificity in type I reactions. Provocation tests, if indicated in a thorough allergy evaluation, should be performed in the shock organ. The provocation methods and interpretation of reactions of this study differ from those of earlier reports. Comparison of results is difficult and standardization of methods is needed.

The results of the skin, bronchial or conjunctival provocation tests and of the radioallergosorbent test (RAST) with dog dander and hair extract preparations from two different producers were compared, 202 asthmatic children were included in the study. The clinical tests, Al-RAST and paper RAST. were performed using only one allergen preparation (Hu 073), while two allergen preparations (e2 and e5) were used in Phadebas® RAST. A good correlation was generally found between the results of the clinical diagnostic tests, the clinical history and the results of RAST. Phadebas RAST e2 was the most specific but the least sensitive: it gave a class 0 result in 18% and class 3–4 in 34.5% of the subjects with a positive provocation test. The corresponding numbers for e5 RAST were 6.0% and 70.2%, respectively. Al-RAST was equally sensitive, but had lower specificity than Phadebas RAST e5. The correlation between Phadebas RAST e5 and paper RAST Hu 073 was excellent, which indicates a remarkable similarity between these allergen extracts. Using sensitive, immunochemically standardized Phadebas RAST e5 or Al-RAST methods, classes 0–1 can be regarded as negative, class 2 as doubtful and classes 3–4 as clinically positive results.

The commercial cat and dog allergen extracts are traditionally prepared from pelt, fur or dander. However, there is increased evidence of the allergenicity of saliva and urine of the animals. We have investigated 25 asthmatic children with a positive cat and/or dog RAST result. All 20 subjects with a positive cat RAST gave a positive skin prick test result to cat saliva, cat urine and cat hair. Analogously, all 20 subjects with a positive dog RAST had a positive skin reaction to dog saliva, urine and dander. In RAST inhibition experiments with dog and cat allergen discs, dog saliva appeared to be at least as potent as a commercial dog dander and hair extract, while cat saliva was less potent than the respective commercial extract. Both dog and cat salivas were clearly more potent than the respective urine. Significant cross-reactivity was observed between cat hair and dog dander in the RAST inhibition, whereas saliva and urine were shown to be more species-specific. An experimental dog dander preparation had about the same specificity as, and even higher allergenic activity than, that of dog saliva or urine. Our results suggest that saliva actually may be the best source of cat and dog allergen preparations. The importance of urine warrants further investigation.

Summary Skin prick tests (SPT) were carried out on 164 asthmatic children using dog dander allergen preparations (A, B1, B2 and D) from three manufacturers. Bronchial and/or conjunctival provocation tests with allergen A were performed on all patients, as well as the Phadebas® RAST (allergen e5). There was a close agreement between the clinical history and the SPT with allergens A and D. The provocation tests and RAST gave results in good agreement with the SPT reactions to all allergens except B1. The overall agreement between the SPT reactions to the different allergens was good. However, significant differences were observed in the allergenic activity of the different preparations and between different batches from the same manufacturer (allergens B1 and B2).